Osteophytes: what are they and how to deal with them

What are osteophytes

“Osteo” means bone in Greek, and “phyto” means plant. Growths form along the edges of bones, in areas that are subject to maximum stress. In the hip joint, this is, for example, the inner surface of the acetabulum. Thinning cartilage does not absorb the load, so the bones rub intensely.

Since the joint is not able to independently restore damaged cartilage, a compensatory mechanism is activated in the body. To prevent bones from being destroyed, osteophytes are formed, which slow down movement and stop the destruction of the joint capsule. This is how pathological ossification of the musculoskeletal system occurs. Thus, osteophytes are the body’s response to increasing load.

Osteophytes and deposits of calcium salts are formations of different structures

Symptoms

Osteophytes grow to a certain size, stop growing and, as a rule, remain unchanged for a long time.

Initially, osteophytes have a cartilaginous structure with foci of ossification. Then they acquire the structure of soft spongy bone. Osteophytes complete their development with the formation of dense, compact bone tissue.

Cases of the development of osteoporosis and processes of destruction of osteophyte bone tissue, which can lead to partial or complete resorption of the bone outgrowth, have been described.

The exception is osteophytes that lead to compression of nerve trunks or penetrate deeply into muscles. Such osteophytes can cause pain of varying degrees of intensity.

In some cases, osteophytes are a protective mechanism during the development of a pathological process in the joint, limiting movement and, thus, protecting the joint from further destruction of the articular surfaces of bones and articular cartilage under load.

In some cases, osteophytes themselves become a source of tissue injury and only aggravate the processes of joint destruction. For example, osteophytes of the ankle joint contribute to pinching of the ankle joint capsule between the bony outgrowth and the articular surface of the talus, which leads to increased pain, swelling and inflammation in the joint.

Reasons for the formation of osteophytes

Bone growths in joints are formed:

due to injuries or bruises;
as a result of inflammation of bones or nearby tissues;
due to congenital or acquired dystrophic changes in the joints, for example due to endocrine disorders.

Most often, osteophytes cause age-related changes in joints or result from wear and tear of cartilage. In the second case, this occurs due to the same type of physical activity or sports overload. When hyaline cartilage fails, ossified areas appear in its place, limiting mobility.

Osteophytes are formed in those who load the joint with the same type of work.

Diagnostics

If a protrusion in the knee area or other symptoms is detected, you should consult an orthopedic traumatologist. The main way to diagnose osteochondromas is x-ray. In the image, the tumor has the appearance of a “cauliflower”, having a thin stalk or a wide base. A typical sign of exostosis is the cortical walls and medullary space that are unified with the maternal bone.

But x-rays do not allow us to assess the structure and size of the cartilaginous cap, especially in children, since the formation of foci of mineralization in it usually occurs in adulthood. The width of the cartilaginous cap is an important diagnostic feature that allows one to detect signs of malignant degeneration. Therefore, to exclude this, an MRI of the knee joint is performed. Detection of cartilage tissue thickness of more than 1.5-2 cm is considered as a sign of malignancy. Additionally, MRI provides comprehensive data on the condition and location of the neurovascular bundle, as well as the hyaline cartilage covering the epiphyses of the femur and tibia. But since malignancy of osteochondromas, especially single ones, occurs extremely rarely, MRI is often not performed until indications for removal of exostosis of the knee joint arise.

Provoking factors

Arthrosis takes a long time to progress. In order for it to move from the chronic first stage to the pathological, painful second stage, a push is needed. Such provoking factors are:

injuries, for example, a fracture of the middle part of a tubular bone (osteophytes form in the form of callus along the edges of the fracture);
rupture of the periosteum (with the help of osteophytes, the body tries to connect the periosteum to the bone);
inflammatory processes (with arthritis, osteomyelitis, brucellosis);
malignant joint diseases, such as sarcoma.

If you have arthritis, your risk of osteophytes forming in your joints increases.

Symptoms of marginal osteophytes of the knee joint

Marginal osteophytes of the knee joint develop for a long time without giving any symptoms. The clinical picture begins to form at the moment when bone tissue growths begin to injure the cartilaginous synovial membrane and even rupture it. This is accompanied by severe pain, limited mobility and signs of acute arthritis.

During periods of remission, when inflammatory reactions subside under the influence of the immune system, the following signs of pathology may appear:

crunching and creaking when walking (bending and straightening the knee);
difficulties when going up or down stairs (a feeling that the knee joint is stuck in one position and something is preventing you from continuing to move);
rapid fatigue of the lower leg and thigh muscles;
pain when walking and at rest;
deformation of the knee joint (in later stages).

Diagnosis requires an initial examination by an orthopedist. The doctor will be able to determine whether the clinical picture is a consequence of deforming osteoarthritis or whether the patient is developing osteophytes. To confirm the diagnosis, X-rays, MRI examinations and ultrasound are prescribed. All these techniques allow you to make an accurate diagnosis. Then treatment begins.

How to fight osteophytes today

The fight against osteophytes is part of the general treatment regimen for coxarthrosis, gonarthrosis or arthrosis of another joint. It is almost impossible to get rid of bone growths. The goal is to reduce pain and expand the range of motion. For this purpose, depending on the stage of arthrosis, the patient is prescribed:

ointments to reduce unpleasant symptoms, such as hydrocortisone;
non-steroidal anti-inflammatory drugs in the form of tablets or injections into the joint;
physiotherapy - laser, magnets, electrophoresis, shock wave treatment.

One of the physiotherapeutic methods of combating pain due to arthrosis is magnetic therapy. What is it based on and why it helps, says the specialist:

Rehabilitation

The duration and complexity of the recovery period depend on the type of surgical intervention performed and the individual characteristics of the patient. When performing marginal resection, discharge from the hospital is usually carried out after 3 days. In this case, no serious restrictions are required. And after 7-10 days, patients can return to everyday activities. With corrective osteotomy, rehabilitation is more complex and lengthy. Patients are required to undergo exercise therapy, physiotherapy, and wear orthoses.

Thus, osteochondroma or exostosis of the knee is a relatively harmless tumor, but sometimes it can reduce the quality of life of patients and lead to complications. In such situations, surgical removal is indicated, since there are no other effective methods of treating the disease.

Is surgery necessary?

If conservative treatment does not help and the patient continues to experience pain, there are two options. Bone formations can be removed surgically. True, this will have to be done regularly, since the problem will not disappear, and osteophytes will continue to form with enviable frequency. Therefore, it makes sense to act radically.

With the help of intra-articular injections of a synovial fluid prosthesis, for example, Noltrexin, it is possible to move the rubbing surfaces apart. Thinning cartilage no longer rubs, and the body does not receive a signal about the need for compensation. Under such conditions, when there is enough synovial fluid, despite damaged cartilage, osteophytes do not form.

Before deciding to have surgery, weigh the pros and cons. Osteophytes in the joints severely limit mobility. But to get it back and get rid of the pain, it is not at all necessary to undergo surgery.

Treatment

The detection of an osteophyte in itself has no clinical value. It is necessary to establish the disease that led to the appearance of osteophytes, otherwise treatment will be ineffective and can only worsen the situation.

If osteophytes do not cause pain and do not significantly limit movement in the joints, then treatment is not required.

A modern and effective method of treating osteophytes is Shock Wave Therapy. Due to its unique properties, the shock wave destroys the structure of the osteophyte and gradual resorption of the osteophyte occurs. A typical example is the treatment of heel spurs. The course of treatment is 5 procedures, usually once a week.

What causes osteophytes and how to get rid of them?

Osteophytes are called bone growths in the area of the spinal column, which have an irregular shape and appear due to calcification of the elements of the ligamentous apparatus, as well as other soft tissues of this area. Intervertebral discs, as well as the joints of the spinal column, wear out over time, and degenerative processes occur in them. Under the influence of regular heavy physical activity, traumatic influences and some other factors, the progression of pathology is significantly accelerated.

What causes osteophytes to appear?

The occurrence of these bone growths is due to the fact that the intervertebral discs gradually wear out under the influence of physical and mechanical factors. At the same time, the ligaments thicken significantly, become more dense, lime accumulates in them, as a result of which the growth of bone formations becomes intense. People over forty years of age have an increased risk of developing osteophytes. Among the causative factors of their occurrence, the following should be noted:

disruption of metabolic processes in the body, obesity resulting from dysregulation of hormone levels in tissues;
the presence of any degenerative-dystrophic processes in the human body;
performing constant heavy physical activity;
traumatic damage to tissues of a given anatomical zone;
prolonged standing, sitting in one position, physical inactivity;
the presence of flat feet, as a result of which depreciation of the spinal tissues is not provided.

Main symptoms of the disease

It should be noted that spinal spondylosis (another name for such bone growths) in men usually begins at an earlier age, but in the fairer sex the disease occurs in a more severe form.

This pathology is characterized by frequent headaches in the occipital region, morning stiffness of the affected part of the spinal column, impaired sensitivity and motor activity of the innervated zones. Auditory and visual disturbances, a feeling of numbness and tingling in the upper or lower extremities (depending on the location of the pathological process) may also sometimes occur.

It should be noted that in some cases, spondylosis may be accompanied by spinal canal stenosis, which results in compression of the spinal cord, and the blood supply also deteriorates due to compression of the arterial vessels that supply local tissues. This is characterized by the appearance of lameness, dizziness and surges in blood pressure.

Diagnostic and therapeutic measures

As for the diagnosis of osteophytes, it must be carried out by a qualified doctor who, even using simple clinical examination methods (especially palpation), can determine the presence of bone growths that are close to the skin. The main instrumental research method in this case is conventional radiography of the spinal column, in which osteophytes are clearly visualized in the images.

The treatment program for spondylosis is aimed mainly at stopping the progression of the pathological process, since it is almost impossible to completely get rid of osteophytes.

Most often, treatment is carried out by a chiropractor or osteopath.
Medications are also prescribed that are aimed at reducing pain and relieving the existing inflammatory process. Patients are taught to strengthen the muscular corset of the neck and lower back, and maintain constant correct posture. Massage sessions, physiotherapeutic procedures are carried out, and patients also engage in therapeutic exercises. Surgical intervention is resorted to only in cases where conservative methods do not bring results and the pain is acute. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr

Prevention

To prevent the formation of osteophytes and avoid walking problems requiring surgical intervention, follow a number of recommendations:

Avoid gaining excess weight - it puts additional stress on the joints of your legs.
Eat properly and variedly - cartilage and bones should receive all the nutrients they need.
Don't get too cold.
Treat knee injuries promptly and correctly, consult a doctor, even if you yourself consider the injury not serious.
When playing sports: do not put excessive stress on your feet, do not run on hard surfaces (such as asphalt), choose the right shoes in which the sole has high shock-absorbing properties, do not land with your legs straight at the knees, if necessary during increased stress on the knees wear a special bandage or bandage them with an elastic bandage.
During menopause, undergo hormonal replacement therapy with drugs individually selected by the treating gynecologist.
At the first symptoms of arthrosis (a feeling of stiffness in the knee, pain), do not delay a visit to a specialist - at stage 1, osteophytes may not yet exist, and if complex treatment is started in time, their formation can be avoided.